Billing for infusion supplies

lcarter77

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Saint Leonard, MD
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Hi All!
I have a provider that is insisting that they can bill for IV Start Kits. I know better than this. I told her that it was included in the therapeutic infusion reimbursement. She said the practice she used to work for was getting reimbursed for them. I have searched and haven't found anything that can substantiate this. Has anyone heard of them getting reimbursed? IF so, what code do I use? Any info would be greatly appreciated!!

L
 

trarut

True Blue
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Columbus, OH
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Supplies are bundled into the administration code, as noted in the CPT guidelines. Just because a supply code makes it past the payer edits doesn't make it appropriate to bill and doesn't mean the payer didn't identify the inappropriate payment and recover it. I've been billing and coding Oncology services for over 20 years and we've never billed for start kits.

I've had some coworkers and managers who have come from facilities make that same argument. I point out that while facilities do have some different rules around billable services, they also capture all services and supplies for reporting purposes but that doesn't mean they were actually billed and paid.
 

lcarter77

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Saint Leonard, MD
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Supplies are bundled into the administration code, as noted in the CPT guidelines. Just because a supply code makes it past the payer edits doesn't make it appropriate to bill and doesn't mean the payer didn't identify the inappropriate payment and recover it. I've been billing and coding Oncology services for over 20 years and we've never billed for start kits.

I've had some coworkers and managers who have come from facilities make that same argument. I point out that while facilities do have some different rules around billable services, they also capture all services and supplies for reporting purposes but that doesn't mean they were actually billed and paid.
Thank you!!! I said the same thing! I just wanted some backup on this one! I appreciate your help!
L
 

trarut

True Blue
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Columbus, OH
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Hope that helps. Also, if you look in the CPT book at the beginning of the infusion codes section, there is a list of bundled supplies and service related to administration. That may help you as well.
 
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